Surg-28. combination of intraoperative mri with electrophysiological monitoring for enhanced brain tumor resection

In this study, 203 patients undergoing craniotomy and tumor resection with iMRI by a single surgeon were followed to determine outcomes. Among these, 124 also underwent electrophysiological mapping of motor (65 of 203), speech (3 of 203) or both (56 of 203). There were no significant differences in age, gender or comorbidities among the participants. Patients undergoing combined motor and speech mapping were less likely to obtain a gross total resection (18% versus 32% of patients undergoing motor mapping only and 42% who received surgery without intraoperative mapping). However, when controlled for tumor location and multifocality, all statistical significance disappeared. Similarly, postoperative deficits were more common among patient undergoing combined speech and motor electrophysiological mapping. However, when the preoperative deficits were factored, no significant differences were found in outcome as determined by delta KPS score. This is despite carrying out surgery in disparate eloquent areas. There were no statistically significant differences in 30-day mortality or permanent neurological deficits. This preliminary data suggests that EPM in combination with iMRI is a safe adjunct that does not lead toward any deleterious outcomes for patients and provides yet another tool to guide the surgeon during resection. This data has not demonstrated a clear benefit on extent of resection or postoperative deficits. More work needs to be done to determine the utility of ...
Source: Neuro-Oncology - Category: Cancer & Oncology Authors: Tags: SURGICAL THERAPY Source Type: research